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Much of the research going on in the area of Wilms tumour is coordinated by the Children's Oncology Group (COG), SIOPE-RTSG (SIOP Wilms Tumour) and Professor Kathy Pritchard-Jones (ICH/UCL). Their main goal is to further research ,improve the treatment and quality of life of children with Wilms tumour and to find better treatments for harder to cure cases.

Biology of Wilms tumours

Research is continuing to unravel how changes in certain genes cause Wilms tumours. Different genes seem to be involved, which might affect how aggressive certain tumours are likely to be and identify those which are more likely to be resistant to treatment or those which are more likely to relapse. The key to identifying hard to treat wilms tumours and more agressive types from the outset lies in the genetic structure of the tumour.

Recent studies have shown that Wilms tumours with certain changes on chromosomes 1 or 16 seem to be more likely to come back after initial treatment. Doctors are now studying whether children with such tumours might benefit from more intensive treatment from diagnosis. Researchers are also studying the molecular changes that seem to cause Wilms tumour cells to grow and spread. This may lead to treatments that are specifically targeted to correct or overcome these changes, to inhibit them or block receptors that allow the tumour to grow. At the moment it has been highlighted that tumours with a p53 mutation may be more difficult to treat. Studies in the USA are currently looking into this.

A recent study called IMPORT, led by UCL collected DNA sequencing data from wilms tumours upon diagnosis and has provided researchers with an insight into how wilms tumour works and has identified key features which will help them treat children more effectively. It will also provide researchers with a resource of tumours from which futher studies can be done.

As doctors have learned how to treat Wilms tumours more effectively, they have begun to look for ways to determine which children might be spared from more intensive treatment. A recent publication by Professor Kathy Pritchard-Jones shows how doxorubicin can now be omitted safely from stage iii intermediate tumours click here for article

Work into liquid biopsies to identify tumour markers and also sequencing of tumours at relapse is currently being undertaken by the team at ICH.

Treatment of Wilms tumours

90% of children diagnosed with wilms tumour will be cured and lead happy healthy lives without little trace of being ill.

However, the outlook for patients with Wilms tumours with unfavorable histology or those which relapse are not as good, and sadly 1 out of 10 children will not survive their disease.

Doctors are continuing to study more intensive and more effective treatments for these children. Newer chemotherapy drugs such as topotecan and irinotecan are now being tested in combination with novel immunology and inhibitor treatments (P53 ad CD56 trials). Gene sequencing of tumours is also providing reeachers with an in depth view of exactly what happens within the tumour. Improved imaging to detect high risk tumours from diagnosis is also being explored click here